How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,047 to $6,310Professionalmedian $269 · 10th to 90th $25 to $562
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $660.69 Median $2,630.27 Typical High $6,918.31 | Facility | None | $660.69 | $2,630.27 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $512.86 | Professional | None | $309.03 | $407.38 | $512.86 |
BCBS Texas Setting Facility Modifier None Typical Low $1,122.02 Median $2,344.23 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,344.23 | $6,760.83 |
BCBS Texas Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $912.01 | Professional | None | $346.74 | $524.81 | $912.01 |
Christus Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,398.83 | Facility | None | $602.56 | $1,819.70 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $676.08 | Professional | None | $371.54 | $489.78 | $676.08 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $4,168.69 | Professional | None | $3,388.44 | $3,388.44 | $4,168.69 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $1,230.27 Typical High $5,128.61 | Facility | None | $407.38 | $1,230.27 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $524.81 | Professional | None | $309.03 | $407.38 | $524.81 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $89.13 Typical High $446.68 | Professional | None | $16.98 | $89.13 | $446.68 |
Providence Setting Facility Modifier None Typical Low $467.74 Median $1,819.70 Typical High $4,466.84 | Facility | None | $467.74 | $1,819.70 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $676.08 | Professional | None | $371.54 | $489.78 | $676.08 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $660.69 | Professional | None | $323.59 | $446.68 | $660.69 |
Wellpoint Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $204.17 Typical High $257.04 | Professional | 52 · Reduced service | $154.88 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $81.28 Typical High $102.33 | Professional | 53 · Discontinued | $61.66 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $302.00 Typical High $380.19 | Professional | 54 · Surgery only | $234.42 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $60.26 Typical High $75.86 | Professional | 55 · Aftercare only | $46.77 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $40.74 Typical High $51.29 | Professional | 56 · Pre-op care only | $30.90 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $281.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $218.78 | $281.84 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $204.17 Typical High $245.47 | Professional | 52 · Reduced service | $154.88 | $204.17 | $245.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $81.28 Typical High $97.72 | Professional | 53 · Discontinued | $61.66 | $81.28 | $97.72 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $302.00 Typical High $371.54 | Professional | 54 · Surgery only | $234.42 | $302.00 | $371.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $60.26 Typical High $74.13 | Professional | 55 · Aftercare only | $46.77 | $60.26 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $40.74 Typical High $48.98 | Professional | 56 · Pre-op care only | $30.90 | $40.74 | $48.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $281.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $218.78 | $281.84 | $346.74 |
Where Texas sits
The same service costs 6.0 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 51st of 51
$295
AK $1,778TX $295
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.